Virtual Field Trips Reservation Form
To schedule a University of Nebraska State Museum Virtual Field Trip, please fill out the form below. You will be contacted within one week to schedule your virtual field trip program(s).

Questions concerning Virtual Field Trips can be directed to
elephant@unl.edu or 402-472-6302

Teacher Name *
Your answer
Name of School *
Your answer
Classroom Grade *
Your answer
Is your class any of the following: *
Required
# of Students *
If you have multiple class periods for which you would like to schedule a VFT program, please list the number of students in each class period.
Your answer
School Address *
Your answer
School City, State, Zip *
Your answer
Teacher Phone Number *
This is the contact number where the tour guide can reach the teacher during the VFT program in case of technical difficulties. Please list your classroom phone or cell phone number.
Your answer
Teacher E-mail Address *
Your answer
ESU Distance Learning Coordinator Name *
Your answer
ESU Distance Learning Coordinator E-mail *
Your answer
ESU Distance Learning Coordinator Phone Number
Your answer
School Tech Coordinator Name
Your answer
School Tech Coordinator E-mail
Your answer
How would you like to connect? *
Contact your ESU distance learning coordinator for this information if you aren’t sure.
Required
Virtual Field Trip
Please select which virtual field trip you would like your class or organization to participate in.
Preferred Dates *
Please list several preferred dates when you would be available to take your virtual field trip(s).
Your answer
Program Start Time(s) *
Please indicate when you would like your virtual field trip program to start. If you are scheduling a VFT program for multiple class periods, please list the time each class period starts.
Your answer
Description of Need
Please describe your description of need to be considered for a virtual field trip scholarship.
Your answer
How did you hear about our virtual field trip program? *
Please let us know how you learned about our virtual field trip program.
Your answer
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